Robotic modified radical neck dissection by bilateral axillary breast approach for papillary thyroid carcinoma with lateral neck metastasis

Kim, Byung Seup; Kang, Kyung Ho; Park, Sung Jun

doi:10.1002/hed.23545

Cited by 59 publications

(36 citation statements)

References 24 publications

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“…None of the studies had randomization performed between the two groups. Six of the studies involved patients with head and neck malignancy who underwent a retroauricular approach to the neck, whereas five of the studies consisted of patients with PTC who underwent a transaxillary approach. The total sample sizes ranged from nine to 143, whereas the robotic and conventional group sample sizes spanned from three to 62 and six to 102, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…The pooled mean age ranged from 36.7 to 61.4 for the robotic group and from 43.5 to 64 for the conventional group. The pooled body mass index (BMI) was obtained from five studies and ranged from 22.7 to 25.4 for patients who underwent robotic approaches and 22.2 to 24.6 for patients who had open neck dissections. Advanced stage primary tumor, classified as either T3 or T4, occurred in 0% to 83.9% in the robotic group and 6.3% to 89.4% in the conventional group.…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, we classified the robotic approach into two major techniques: transaxillary and retroauricular. The gasless unilateral axillary approach, gasless unilateral axillo‐breast approach, bilateral axillo‐breast approach, and combined transaxillary and retroauricular approach were designated together as the transaxillary technique. The retroauricular, postauricular, and modified facelift approaches comprised the retroauricular technique …”

Section: Methodsmentioning

confidence: 99%

“…Following this, Kim et al combined the facelift and transaxillary approach to perform neck dissections in head and neck squamous cell carcinoma. Multiple case series and comparative studies, primarily out of South Korea, subsequently highlighted the feasibility of nodal dissection through robotic transaxillary, retroauricular, and modified facelift approaches . Despite the embrace of this technology in East Asia, studies remain limited in the head and neck surgical literature.…”

Section: Introductionmentioning

confidence: 99%

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Robotic versus conventional neck dissection: A systematic review and meta‐analysis

et al. 2018

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Objective: The aim of this systematic review is to compare the perioperative outcomes of robotic versus conventional neck dissection in patients with head and neck malignancy.Methods: An electronic search of PubMed, Web of Science, and EMBASE databases was conducted. We included studies with direct comparisons of robotic and open neck dissections and performed dual, independent data extraction for primary outcomes of nodal yield, recurrence rate, subjective cosmetic assessment, operative time, length of stay, and rates of perioperative complications. Data were pooled using random effects meta-analysis to determine the standardized mean difference (SMD), absolute risk difference (RD), and 95% confidence intervals (CI).Results: Eleven comparative studies comprising 225 robotic and 430 open neck dissections met the final selection criteria. All studies had low to moderate risk of bias. Robotic surgery improved cosmesis (SMD 1.15, 95% CI 0.73 to 1.56) but also increased operative time (SMD 1.94, 95% CI 1.25 to 2.63). Total nodal yield, pathological nodal yield, recurrence rate, rates of perioperative complications, and length of stay were not significantly different between the two groups, and the 95% CIs suggested that false negative results were unlikely. The results remained consistent after stratification by pathology and robotic technique.Conclusion: Although robotic neck dissection may offer similar perioperative outcomes compared to conventional neck dissection, it requires significantly more operative time. Whereas cosmesis was found to be superior among the robotic cohort, this must be viewed cautiously given the nonvalidated measurement tool that was used and the inherent reporting bias associated with it.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Robotic versus conventional neck dissection: A systematic review and meta‐analysis

et al. 2018

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“…In general, patients are deeply concerned about a visible scar in the neck [11]. Recently, remote-access incisions, such as the transaxillary, axillo-breast, and postauricular facelift incisions, have been developed for LND of thyroid cancer, with the aim of concealing the scar in the neck area, and thereby demonstrating the interest of both surgeons and patients in cosmetic results [6, 15–17]. Even in the conventional transcervical approach, there have been attempts to reduce the scar length or to design a less noticeable skin incision for better cosmesis [9].…”

Section: Discussionmentioning

confidence: 99%

Low transverse incision for lateral neck dissection in patients with papillary thyroid cancer: improved cosmesis

Song

Kim

et al. 2017

World J Surg Onc

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BackgroundVarious incisions and approaches have been developed for lateral neck dissection. The purpose of this study was to compare the surgical and cosmetic outcomes of a single low transverse incision with the hockey stick incision for lateral neck dissection (LND) in patients with papillary thyroid carcinoma (PTC).MethodsWe retrospectively analyzed 97 patients with PTC who underwent therapeutic LND and total thyroidectomy by low transverse incision (62 patients) or hockey stick incision (35 patients). We compared the operative results, cosmetic outcomes, objective scar measurement, and sensory disturbance between the two groups.ResultsThe number of harvested and metastatic lymph nodes, Vancouver Scar Scale scores, and sensory change were not significantly different between the two groups. The mean number of harvested lymph nodes in level II was 9.82 vs. 9.63 (P = 0.885) (transverse incision vs. hockey stick incision, respectively) and in level V was 6.36 vs. 5.63 (P = 0.597). However, subjective satisfaction with the scar and neck contour was higher in the low transverse incision group compared with the hockey stick incision group. Scores for scar consciousness and sensory change were not significantly different between the two groups.ConclusionsA single low transverse incision may provide equivalent surgical outcomes and superior cosmetic outcomes compared with the hockey stick incision for LND in PTC.

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Bilateral Axillo-Breast Approach (BABA) Robotic Thyroidectomy

Choi

Lee

2021

Robotic Surgery

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Robotic modified radical neck dissection by bilateral axillary breast approach for papillary thyroid carcinoma with lateral neck metastasis

Abstract: Robotic modified radical neck dissection using BABA is safe and shows oncologic and postoperative outcomes comparable to those of the open procedure.

Cited by 59 publications

References 24 publications

Robotic versus conventional neck dissection: A systematic review and meta‐analysis

Robotic versus conventional neck dissection: A systematic review and meta‐analysis

Low transverse incision for lateral neck dissection in patients with papillary thyroid cancer: improved cosmesis

Bilateral Axillo-Breast Approach (BABA) Robotic Thyroidectomy

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